Destructive <scp> <i>Erysipelothrix rhusiopathiae</i> </scp> Endocarditis Confirmed on Valve Tissue Culture After Persistent Blood Culture Negativity

IE underscoring the critical role of advanced tissue diagnostics in high-burden, culture-negative endocarditis. Further, this case reinforces the need for clinicians to maintain a high index of suspicion for this organism in patients with relevant environmental exposures, ensuring timely initiation of appropriate antibiotic regimens particularly given its intrinsic resistance to commonly used empirical endocarditis therapies.